Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, et al
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Lactate suppresses T cell-mediated immune responses by activating the HIF-1/NDUFA4L2 signaling pathway in DCs and controls immune escape via paracrine activation of GPR81 on DCs (129) ( Figure 2 )
Shufelt CL, Bairey Merz C
If the MMA levels are elevated that means you are deficient in Vitamin B12, but more specifically you are deficient in adenosylcobalamin which is a specific form of B12 for energy and mitochondria function so supplementation with methylcobalamin may not be the best way to improve this